that’s no joke

On my way to the dreaded mammogram, I had my five minutes of fame. A word about the mammogram first. It’s one of those annual things we have as a luxury of high funding from the breast cancer prevention lobby and a generous if lop-sided health care system. Demographics would say I’m not at risk but the statistics these days suggest anyone with a hormonal system is. (That includes you gentlemen.) Still and all, I’ve avoided it for the last four years, seeing it mainly as a waste of good health care dollars to make a glass plate sandwich of my boobs – although it is a good test of my skills with the Anapannasati Sutra. But I now have a new family physician who is much too young to be ordering me about but I’m going to let her because as a health care professional myself, I know I am the worst patient anyone can have.

So. On my way to the dreaded mammogram, I had my five minutes of fame. At the doors of the hospital, which is a lovely 10 minutes walk from my office, was a film crew polling patients about the health care system. The Canadian Medical Association Annual General Meeting is coming up and this was to be a feature at their gathering. They asked questions that were actually quite pointed about our health care system.

My answers in narrative form: The Health Care System is broken. That simple fact makes little waves in battle for dollars. There’s a lot of blaming and shaming with fingers fiercely pointed at organizational dysfunction. But under the egos that place research and body counts as gold standards for health care delivery are very frightened people who are staunchly protecting their turf. And in their fear, it is unlikely that they will see the futility of throwing more money into a broken bowl. What they miss is that efficacy studies – while I am a strong advocate of them – mean squat when the most vulnerable populations in our province are literally dying as they wait on long lists for care.

Do we need more money poured into the medical system? Not if it excludes mental health and long term care for the elderly. I obviously have a bias but it’s justified. Mental Health Services are only free if you see a Psychiatrist. And few people can because you have to have a family physician who refers you. (It’s a way of circulating those dollars.) These days fewer and fewer people have a family physician. Because, guess what? There’s a dirth of physicians. It costs too much to train them and there are too few spaces in medical schools for the number we actually need. Sure, you can see a Psychologist but unless you have one who will adjust their fees and, even if you do, you need an extended health care plan for what it costs. And, guess what? Fewer and fewer people have those because organizations can’t really afford them. And so the wheel turns.

Of course, there’s an obvious solution. Bring all the para-medical professionals under the umbrella of Health Care Services. Create a sangha of professionals who are willing to contribute as a community. It means seeing suffering as our communal diagnosis and treatment as our practice. It means taking on the desire to bring all beings out of their hell realms simply because that’s what we must do. But that also means letting go of our turf and the turf wars. It might even mean seeing each other as equals facing a common end point.

Likely? I don’t know. It’s the old joke: How many Health Care professionals does it take to change a light bulb?

We’ll never know because every time there’s one to be changed, the program ended last week because of funding cuts.

And that’s no joke.

that’s a good thing

This I know in my core but it’s hard to believe that the path to joy and liberation begins with getting into close contact with your suffering.  It’s hard to believe if I come at it from a stance of “prove it” or “show me the numbers.”  Ultimately, practice has little to do with proving hypotheses or data crunching.  Yet when I bring my awareness to my suffering (in all its multi-faceted forms), I am collecting data and testing hypotheses.  And, I’m exquisitely aware that the primary investigator often has a strong bias to undermining the project.

In the years we’ve been teaching our courses on skillful ways to meet life (Mindfulness-Based-interventions), I’ve noticed an interesting paradox.  People get worse before they get better.  Sometimes.  Some people get worse and it doesn’t change over 8-weeks but they’re OK with it.  I’ve flagged this phenomenon on various list serves only to be greeted with the usual internet version of a blank look.  Being very confident in my teaching skills, I just assumed everyone was blown away by my brilliance and didn’t want to venture into deep waters.  Right.

And now, there’s actually a Scientific article that shows – with fascinating arrows and circles that would make Google blush – exactly what that paradox is all about!  Guess what?  Attention to suffering increases psychological distress at the same time as it decreases it through other aspects of awareness.

In their article on “Deconstructing Mindfulness,” Coffey and her colleagues showed that attention had a direct effect on increasing distress.  And, it also increased clarity about one’s negative emotion which in turn reduced rumination and psychological distress.

Well.  I hate to say I was right.  Because I probably wasn’t.  All I ever noticed in our course participants is that they became more aware of their physical pain (ratings of experienced pain went up after the course).  But the pain also interfered less with they lives (scores dropped after the course) because they were able to discern between pain as the physical arising of pain and suffering as the emotional attachment to not having pain arise.  I’m sure all this comes together to buttress some data egghead  (like me) somewhere.  Out here in Health Care Land, we need these factors of belief which allow us to say, “If you practice, then you will see changes.”

Yet strangely, it seems to increase my faith in the process too.  When I feel things are just not panning out and I’m aware of being eyeball deep in my usual septic tank, maybe now I can see it as a call to bring a deeper awareness to the nature of that suffering.  And, that is a good thing.